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HCPCS L2128 Fee Schedule

Last Verified: December 2025

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Knee ankle foot orthosis(KAFO), fracture orthosis, femoral fracture cast orthosis, custom-fabricated
Key FactDetail
Service Type

Orthotic Procedures and services

Knee-ankle-foot Orthotics

Complexity LevelHigh

National average reimbursement for HCPCS L2128 by major payers:

bcbs

$1,888.52

uhc

$1,143.10

aetna

$1,196.31

cigna

$2,284.86

Preview provider-level rates for...
For billing codeHCPCS L2128
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS L2128

United
L2128$1306.571689736282 - THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY586002961GARural Acute Care Hospital (282NR1301X)
United
L2128$1088.811083711691 - TY COBB HEALTHCARE SYSTEM, COBB MEMORIAL HOSPITAL580633978 - (GA) COMMUNITY SERVICES GROUP INCGARural Acute Care Hospital (282NR1301X)
United
L2128$839.001457329435 - PAULDING MEDICAL CENTER, INC., WELLSTAR PAULDING HOSPITAL582095884 - (GA) PAULDING MEDICAL CENTER INCGAGeneral Acute Care Hospital (282N00000X)
United
L2128$839.001083711691 - TY COBB HEALTHCARE SYSTEM, COBB MEMORIAL HOSPITAL580633978 - (GA) COMMUNITY SERVICES GROUP INCGARural Acute Care Hospital (282NR1301X)
United
L2128$875.081316938459 - NAVICENT HEALTH OCONEE, LLC, NAVICENT HEALTH BALDWIN582359398 - NAVICENT HEALTH OCONEE LLCGAGeneral Acute Care Hospital (282N00000X)
United
L2128$642.501902957541 - WILDWOOD SANITARIUM INCORPORATED, WILDWOOD MEDICAL CLINIC586039864 - (GA) WILDWOOD SANITARIUM INCORPORATEDGAGeneral Acute Care Hospital (282N00000X)
United
L2128$907.171396770004 - HOSPITAL AUTHORITY OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER814817422GARural Acute Care Hospital (282NR1301X)
United
L2128$1306.571033435664 - SMITH OF GEORGIA, SMITH NORTHVIEW HOSPITALISTS271652335 - (GA) SMITH OF GEORGIAGAGeneral Acute Care Hospital (282N00000X)
United
L2128$2772.331225281603 - EMORY CRAWFORD LONG HOSPITAL582030692 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
United
L2128$963.761417157405 - EMORY HEALTHCARE901116753GAGeneral Acute Care Hospital (282N00000X)
United
L2128$963.761356860621 - CHI MEMORIAL HOSPITAL822748395 - CHI MEMORIAL HOSPITAL - GEORGIAGAGeneral Acute Care Hospital (282N00000X)
United
L2128$963.761801883780 - TANNER MEDICAL CENTER, INC, TANNER HEALTH SYSTEM581790149 - (GA) TANNER MEDICAL CENTER INCGAGeneral Acute Care Hospital (282N00000X)
United
L2128$1211.681619040284 - QUEST DIAGNOSTICS VENTURE LLC232933949PAClinical Medical Laboratory (291U00000X)
United
L2128$923.531811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM474393589 - (GA) EFFINGHAM HOSPITAL INCGACritical Access Hospital (282NC0060X)
United
L2128$923.531730110826 - EVANS MEMORIAL HOSPITAL, INC.582257925 - (GA) EVANS MEMORIAL HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS L2128 vs. Other Knee-ankle-foot Orthotics Codes

The HCPCS L2128 code is part of the Orthotic Procedures and services services used for Knee-ankle-foot Orthotics. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS L2128 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
L2126-HCPCSHighKnee ankle foot orthosis (KAFO), fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom-fabricated
L2128-HCPCSHighKnee ankle foot orthosis(KAFO), fracture orthosis, femoral fracture cast orthosis, custom-fabricated
L2132-HCPCSModerateKnee ankle foot orthosis(KAFO), fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L2128. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L2128 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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